Vertebral Compression Fracture

For people 60 years old and older with back pain, it may be the result of normal aging. However, back pain can occur from a vertebral compression fracture (VCF). Vertebrae are the small bones that stack on one another to form the spine. One or more small fractures of a vertebra is a common occurrence for postmenopausal women.

How common are VCFs?

Experts estimate that 10 million people in the U.S. suffer from osteoporosis, with an additional 34 million having osteopenia (low bone mass). Vertebral compression fractures mainly affect women, with a 4:1 ratio (women to men). VCFs affect around 25% of all postmenopausal women, and are reported in almost 40% of women 80 years old and above.

What is the cause of vertebral compression fractures?

A VCF occurs as a result of collapse of the vertebral body. These fractures most often occur in the thoracic spine (middle portion), especially the lower region. VCFs are caused by metastatic tumors, trauma, and osteoporosis. For a patient with weak bones, a VCF can occur with something simple as sneezing or making a twisting motion. VCFs are rare in people with healthy spines, but can occur from a hard fall or car accident.

Who is at risk for VCF?

The two groups of people most at risk for a spinal vertebral compression fracture are people with bone weakness due to osteoporosis and individuals who have bone cancer. However, other risk factors are:

Advancing age

White or Asian race

Smoking cigarettes

Early menopause

Being underweight or thin

What is the treatment for vertebral compression fracture?

There are several treatment options for VFC, and the choice depends on the severity of the fracture, the extent of the pain, and the patient’s health status. Options include:

Medications – The pain management specialist can prescribe bone-strengthening drugs to stabilize and restore bone loss, such as Fosamax and Actonel. In addition, muscle relaxants and opioid pain medicines are used short-term to alleviate pain.

Bracing – A back brace gives external support to the vertebra that is fractured, and it will limit range of motion and mobility so the bone can heal. Braces are used short-term under a doctor’s supervision, however, because they may lead to loss of muscle strength with excessive use.

Physical therapy – Once a VCF is confirmed, the doctor will order physical therapy for pain relief. Techniques used by the therapist include heat therapy, massage, ultrasound, and electrical stimulation.

Vertebroplasty/kyphoplasty – These procedures involve injecting bone cement into the fractured vertebra. Once the cement hardens, it restores bone height and alleviated pain. In a large study of more than 650 participants, most people reported significant pain relief and improved mobility following vertebroplasty.

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